Coronavirus concept. Note COVID-19, Protective medical mask and pill capsules for treatment coronavirus. Novel corona virus outbreak. Epidemic from Wuhan, China. Coronavirus drugs on wooden table.
By Annette Newell
They believe that Oregons losing ground to the pandemic. Now, the states unions, doctors and nurses have created a new group, called the Oregon Public Health Coalition.
Theyre demanding more masking, more testing, and more locally produced personal protective equipment.
The groups organizer is Portland pediatrician Dr. Lisa Reynolds. She says Oregons made progress fighting COVID-19, but is losing ground. Although we are instituting some good measures in trying to stop the spread of COVID, what were doing thus far has not been sufficient, she says.
She points to positive test rates climbing back up in Oregon, to levels they were at before the stay home orders in March, saying Im not calling for another shut down, but it seems that the gains we made then have been slipping.
She says fortunately masks work to help stop the spread of the virus, but doesnt see enough people wearing them.
Were still seeing outbreaks in food processing plants, in the Oregon Employment Division, so I think masking should be in all workplaces that are indoors.
The group want to see more, enforced, workplace requirements to wear masks.
We are so lucky that masking works to slow the spread of COVID. And I believe that part of our rise in numbers is that we arent really seeing the masking thats currently called for by the Governor, says Reynolds.
Another area that needs improvement, is testing for COVID-19. We have a heck of a time getting tests for our patients, Dr. Reynolds says.
So shes organized the coalition of health care and workers groups. She says they include, Front line workers in grocery stores and hospitals, in the employment division for example and farm workers as well. So it seems like a natural group to bring together.
The group wants the state to make sure theres more locally made personal protective equipment, or P.P.E.
Oregons an innovative state. Were really calling for locally produced, locally sourced, locally made P.P.E., so that we can be self sufficient,Reynolds said.
Dr. Reynolds is a candidate for an Oregon House seat in November.
KENNEWICK Benton-Franklin Health District announced today that beginning Tuesday, COVID-19 testing at the Toyota Center in Kennewick and the HAPO Center in Pasco hours are changing.
Toyota Center, Kennewick 7am 12pm
Hapo Center, Pasco 7am 1pm
The testing sitesare open Tuesdays through Saturdays. No medical orders are required and the testing is free to all. Participants should bring an insurance card if they have one. No one will be denied testing if they dont have insurance. Testing continues to be done on a first-come, first-served basis.
The sites are open to anyone who believes they should be tested; people with COVID-19 symptoms as well as anyone who has been exposed to the virus are urged to get tested.
Test results will be received by telephone in three to seven days. Negative test results are sent by text message; those with positive tests will receive a telephone call. Written results will also be mailed and received within 10 days.
The drive-through community testing is a joint effort by Benton-Franklin Health District, Washington State Department of Health (DOH), Benton County Emergency Management, Franklin County Emergency Management, and the Washington National Guard.
"Leptin regulates the immune cell number as well as its function," Dr. Rebello said.
NEW ORLEANS Doctors have been telling us that, along with diabetes and high blood pressure, obesity is putting our population at risk for getting very sick and even dying from COVID-19.
Well now, two Louisiana doctors are the first to uncover that potential link with obesity.
You may remember the British prime minister talking about losing weight after COVID-19.
"When I went into ICU when I was, I was very, I was way overweight. Im only about 5 foot 10, the outside, and I was too fat," said British Prime Minister Boris Johnson.
First some background. The hormone leptin tells your brain to lower your appetite. Its the shut-off valve for hunger. The more fat cells you have, the more leptin you have in your body. But heres the catch, doctors know that in people with obesity, the hormone leptin may not be working right.
"So the fat cells are releasing or secreting leptin. The brain is not getting the message to lower appetite," explained Dr. Candida Rebello, who works in pharmacology-based clinical trials at LSU Pennington Biomedical Research center.
And now Dr. Rebello and her colleague Dr. John Kirwan, of LSU Pennington Biomedical Research Center, are the first to make the connection in what may be the reason that high amounts of leptin in people with obesity is causing serious, even fatal COVID-19 reactions. And its because leptin has another job.
"Leptin regulates the immune cell number as well as its function," Dr. Rebello said.
So if your leptin is out of wack, so is your weight and your immune system, which is needed to fight all infections. Thats why obesity puts you at serious risk of death even with the flu. And just like we have medicines to lower blood pressure, Dr. Rebello is now looking for a treatment to lower leptin.
"At this time the only way that can, that leptin levels can be reduced is through weight loss. Bariatric surgery has shown to reduce leptin levels. So my thing is prevention. Even if you are overweight, or you have obesity, at this time its never too late to take steps to reduce that," Dr.Rebello said.
She also wants to make sure that a coronavirus vaccine is tested and works in people with obesity.
"Obesity is a disease like any other disease, like diabetes and like hypertension," Dr. Rebello said. "Obesity is a disease."
The doctors have not yet looked at the connection with obesity and COVID-19 in children. But they say that pregnant women make more leptin and remind us that the CDC says expectant mothers are at higher risk for coronavirus complications.
Get breaking news from your neighborhood delivered directly to you by downloading the FREE WWL-TV News app now in the IOS App Store or Google Play.
Stay up-to-date with the latest news and weather in the New Orleans area on the all-new free WWL TV app. Our app features the latest breaking news that impacts you and your family, interactive weather and radar, and live video from our newscasts and local events. LOCAL & BREAKING NEWS * Receive r...
At-home testing could transform the fight against the novel coronavirus. USA TODAY
Ohio Gov. Mike DeWine tested positive for COVID-19Thursday using a rapid test conducted as part of protocol to greet President Donald Trump at Clevelands Burke Lakefront Airport.
TwoPCR teststaken later that day ultimately found DeWine tested negative.
"This is the same PCR test that has been used over 1.6 million times in Ohio by hospitals and labs all over the state, DeWine said in a released statement soon after the second tests results were released.
DeWines COVID scare underscores the fact thatnot all tests work the same way, nor do they alwaysprovide identical results. Even the same testtaken twicecan show contradictory outcomes.
"It's not that a test is good or bad," explained Dr.Dr. Gary Procop, the director of medical microbiology at theCleveland Clinic."Understand the test characteristics and use it correctly."
Dr. Michael Mina, an infectious disease epidemiologist at the Harvard T.H. Chan School of Public Health, saidDeWine's ability to quickly get asecond test showed "the system worked as it should."
Every test sometimes gives false positives which is better than telling someone they don't have COVID-19 when they do and being able to get a new result within a few hours meant he was inconveniencedonly briefly. "It's a whole lot better than if we weren't testing him at all and he were positive."
Here are answers to seven common questions about diagnostic COVID-19 testing. These tests are different thanantibody tests, which are usedto determine whether someone has had COVID-19 in the past not an active case.
Earlier: Ohio Gov. Mike DeWine tests negative on second COVID-19 test
USA TODAY Editorial Board: Time to get serious about COVID-19 testing
A rapid test, explained Dr. Sheldon Campbell, aprofessor of laboratory medicine at Yale School of Medicine, is a catch-all term for any quick test. Any test that provides results in 30 minutes to one hour, he said, falls under the umbrella of rapid testing.
"Seriously, its not a specific technical term," he told USA TODAY.
In rapid testing, explained Procop, there are two kinds of tests antigen tests and nucleic acid tests.
An antigen test, Campbell said,looks for the proteins that make up the virus coating.
Think of the virus like an M&M, Campbell suggests. Antigen tests look for traces of the hard-shell exterior of the virus, so to speak.
While they provide results more rapidly, they are not a perfect test. The Food and Drug Administration states that antigen tests are more likely to miss active coronavirus infections, and thus, cannot definitively rule out whether someone has COVID-19. DeWine's first test was an antigen test.
A PCR (polymerase chain reaction) test searches for the viral genome.This test, explained Campbell, makesthe virus easier to detect by "making a billion copies of a single target bit of the virus genome."
To go back to the M&M analogy, Campbell likens the viral genome to the chocolate core of the candy.
These tests are more commonand have a higher rate of accuracy.
Here's where things get a bit tricky. Generally, PCR tests tend to be more reliable.
"Its both more likely to detect the SARS-CoV-2 virus and usuallyless likely to give a positive signal if no virus is present," said Campbell.
But Procop says the type of test is less relevant than the context in which it is performed. In a screening context, a patient generally wouldn't have symptoms of COVID-19, whereas in a diagnostic setting, patients get tested because they show symptoms.
"If you're using a highly sensitive test in a diagnostic setting," he said,"you don't need follow up. If you use it in a screening setting, you should have confirmation."
Essentially, if you're taking a test out of an abundance of caution and don't show any symptoms it's worth taking another one in the case of a false positive.
The super-short answer, joked Campbell, is that "(expletive) always happens." Anumber of factors contribute to the possibility that any lab test could result in incorrect outcomes.
Each test provides its own slew oferrors.
Antigen tests get false results because its procedure requires "sticking a labeled probe to the virus proteins."
"Despite the best efforts of the people who design the tests, sometimes the probe sticks to non-virus sticky stuff in the sample," Campbellsaid.
For PCR tests, the same sensitivity that contributesto its accuracy can create false positives. Abit of viral RNA from a previous patient can turn a testpositive.
There are also human errors that come into play, whether lab specimens improperly collected or labeled, or manufacturing errors with testing kits.
Absolutely. It remains unclear why that is, Campbell said, but a common theory he suggested is that "bits of non-infectious virus" slowly work their way out of the body even after symptoms have vanished.
"Some folks with COVID-19 stay positive for days or weeks after they get better," Campbell said.
That's also why the U.S. Centers for Disease Control and Prevention, explained Procop, changed its criteria for employees returning back to work,from two weeks to 10 days after a positive test.
"There'sa long tail of positivity after patients have recovered and we believe it's clinically meaningless," he said.
Expect the long swab. There are different nasal swabs with varying degrees of efficacy.
The long swab, otherwise known as the nasopharyngeal swab, is probably the bestand is most common if you do demonstrate symptoms of COVID-19.
An alternative is thenasal mid-turbinateswaband a less-invasive "anterior nares"swab, which are less effective but sufficient.
Still, the long swab is the gold standard. Campbell puts it this way: "The swab goes farther up your nose than maybe you thought it should, and done right it burns when its up there.But its over quickly, and feeling the burn means you know your test was done right."
Follow Joshua Bote on Twitter: @joshua_bote.
Autoplay
Show Thumbnails
Show Captions
Read or Share this story: https://www.usatoday.com/story/news/health/2020/08/07/mike-dewine-questions-covid-19-testing-answered/3317060001/
Of all frightening ways that the SARS-COV-2 virus affects the body, one of the more insidious is the effect of COVID-19 on the brain.
It is now clear that many patients suffering from COVID-19 exhibit neurological symptoms, fromloss of smell, to delirium, to an increased risk of stroke. There are also longer-lasting consequences for the brain, includingmyalgic encephalomyelitis /chronic fatigue syndromeandGuillain-Barre syndrome.
These effects may be caused by direct viral infection ofbrain tissue. But growing evidence suggestsadditional indirect actionstriggered via the viruss infection of epithelial cells and the cardiovascular system, or through the immune system and inflammation, contribute to lasting neurological changes after COVID-19.
I am a neuroscientistspecializing in how memories are formed, the role of immune cells in the brain andhow memory is persistently disruptedafter illness and immune activation. As I survey the emerging scientific literature, my question is: Will there be a COVID-19-related wave of memory deficits, cognitive decline and dementia cases in the future?
Many of the symptoms we attribute to an infection are really due to the protective responses of the immune system. A runny nose during a cold is not a direct effect of the virus, but a result of the immune systems response to the cold virus. This is also true when it comes to feeling sick.The general malaise, tiredness, fever and social withdrawalare caused by activation of specialized immune cells in the brain, called neuroimmune cells, and signals in the brain.
These changes in brain and behavior, although annoying for our everyday lives, are highly adaptive and immensely beneficial. By resting, you allow the energy-demanding immune response to do its thing. A fever makes the body less hospitable to viruses and increases the efficiency of the immune system. Social withdrawal may help decrease spread of the virus.
In addition to changing behavior and regulating physiological responses during illness, the specialized immune system in the brain also plays a number of other roles. It has recently become clear that theneuroimmune cells that sit at the connectionsbetween brain cells (synapses), whichprovide energyandminute quantities of inflammatory signals, are essential for normal memory formation.
Unfortunately, this also provides a way in which illnesses like COVID-19 can cause both acute neurological symptoms andlong-lasting issues in the brain.
During illness and inflammation, the specialized immune cells in the brain become activated, spewing vast quantities of inflammatory signals, and modifying how they communicate with neurons.For one type of cell, microglia,this means changing shape, withdrawing the spindly arms and becoming blobby, mobile cells that envelop potential pathogens or cell debris in their path. But, in doing so, they also destroy andeat the neuronal connections that are so important for memory storage.
Another type of neuroimmune cellcalled an astrocyte, typically wraps around the connectionbetween neurons during illness-evoked activation and dumps inflammatory signals on these junctions, effectively preventing the changes in connections between neurons that store memories.
Because COVID-19 involves amassive release of inflammatory signals, the impact of this disease on memory is particularly interesting to me. That is because there are both short-term effects on cognition (delirium), and the potential for long-lasting changes in memory, attention and cognition. There is also anincreased risk for cognitive decline and dementia,including Alzheimers disease, during aging.
If activation of neuroimmune cells is limited to the duration of the illness, then how can inflammation cause long-lasting memory deficits or increase the risk of cognitive decline?
Both the brain and the immune system have specifically evolved to change as a consequence of experience, in order to neutralize danger and maximize survival. In the brain, changes in connections between neurons allows us to store memories and rapidly change behavior to escape threat, or seek food or social opportunities. The immune system has evolved to fine-tune the inflammatory response and antibody production against previously encountered pathogens.
Yet long-lasting changes in the brain after illness are also closely linked to increased risk for age-related cognitive decline and Alzheimers disease. The disruptive and destructive actions of neuroimmune cells and inflammatory signaling can permanently impair memory. This can occur throughpermanent damage to the neuronal connections or neurons themselvesand also via moresubtle changes in how neurons function.
The potential connection between COVID-19 and persistent effects on memory are based on observations of other illnesses. For example, many patients who recover fromheart attack or bypass surgeryreport lastingcognitive deficits that become exaggerated during aging.
Another major illness with a similar cognitive complications issepsis multi-organ dysfunction triggered by inflammation. In animal models of these diseases, we also see impairments of memory, and changes in neuroimmune and neuronal function that persist weeks and months after illness.
Evenmild inflammation,including chronic stress, are now recognized as risk factors for dementias and cognitive decline during aging.
In my own laboratory, I and my colleagues have also observed that even without bacterial or viral infection, triggering inflammatory signaling over a short-term period results inlong-lasting changes in neuronal function in memory-related brain regionsandmemory impairments.
It will be many years before we know whether the COVID-19 infection causes an increased risk for cognitive decline or Alzheimers disease. But this risk may be decreased or mitigated through prevention and treatment of COVID-19.
Prevention and treatment both rely on the ability to decrease the severity and duration of illness and inflammation. Intriguingly, very new research suggests that common vaccines, including theflu shot and pneumonia vaccines, may reduce risk for Alzheimers.
Additionally, several emerging treatments for COVID-19 are drugs thatsuppress excessive immune activationand inflammatory state. Potentially, these treatments will also reduce the impact of inflammation on the brain, and decrease the impact on long-term brain health.
COVID-19 will continue to impact health and well-being long after the pandemic is over. As such, it will be critical to continue to assess the effects of COVID-19 illness in vulnerability to later cognitive decline and dementias.
In doing so, researchers will likely gain critical new insight into the role of inflammation across the life-span in age-related cognitive decline. This will aid in the development of more effective strategies for prevention and treatment of these debilitating illnesses.
Natalie C. Tronson is an Associate Professor of Psychology at the University of Michigan.
This article was published originally on The Conversation. Read the original here.
As California surpassed 10,000 coronavirus deaths this week, the head of the states Health and Human Services Agency, Dr. Mark Ghaly, said a breakdown in the main disease reporting system had undercounted as many as 300,000 test results.
Our data system failed, and that failure led to inaccurate case numbers, Dr. Ghaly said.
The malfunctions in the data system were compounded in recent days by huge backlogs in testing in some California counties results are taking more than two weeks to process muddying the overall picture of the viruss progression in the nations most populous state.
The breakdown dates to July 25, when a server failed, and the agency separately stopped receiving data from one of the largest labs in the state, Dr. Ghaly said. The missing data, which could amount to thousands of positive test results not previously recorded, would be added to the system within days, he said.
With well over 500,000 cases and 10,042 deaths, California has the third highest coronavirus death toll in the United States, behind New York, which has had more than 32,000 deaths, and New Jersey with over 15,000, according to a New York Times database. On a per capita basis, California ranks 29th in reported coronavirus deaths.
Despite the undercounting of cases, officials say they believe the overall encouraging trends reported by Gov. Gavin Newsom earlier in the week still hold. Mr. Newsom had reported a decline of more than 20 percent in the seven-day average of cases.
We believe that the trend has been stabilizing and coming down, Dr. Ghaly said, an assessment partly based on hospitalization rates, which are calculated using separate data systems.
The report, published on Wednesday by the Dutch newspaper De Volkskrant and 1Vandaag, a current-affairs show, focused on a retirement home where in June almost an entire ward of patients was infected.
Despite wearing face masks continuously except for lunch breaks, 18 staff members were also infected. When a newly installed air-ventilation system was inspected, the health authorities found large quantities of the virus on the mesh covering air intake and extraction units and in its filters.
There is simply no other explanation possible, this is how everybody there got infected, all at the same time, through aerosols, said Maurice de Hond, a data specialist who has long criticized the Dutch health authorities for ignoring spread through aerosols. We need to realize this before autumn comes and more people will gather indoors.
It is unclear why the Dutch National Institute for Public Health and the Environment has kept its findings secret, but it did tacitly adjust the guidelines for ventilation, according to De Volkskrant. Three days after the report was released internally, the organization started publicly advising to avoid recirculation of air in spaces where several people are present, and refresh the air as often as possible.
Reporting was contributed by Maria Abi-Habib, Geneva Abdul, Hannah Beech, Emily Bobrow, Keith Bradsher, Luke Broadwater, Emma Bubola, Julia Calderone, Benedict Carey, Niraj Chokshi, Emily Cochrane, Patricia Cohen, Melissa Eddy, Thomas Erdbrink, Jacey Fortin, Sheera Frenkel, Maggie Haberman, Mike Ives, Cecilia Kang, Annie Karni, David Leonhardt, Patrick J. Lyons, Tiffany May, Giulia McDonnell Nieto del Rio, Constant Mheut, Sarah Mervosh, Saw Nang, Richard C. Paddock, Eileen Sullivan, Jim Tankersley, Pranshu Verma, Neil Vigdor, Sui-Lee Wee, Katherine J. Wu, Ceylan Yeginsu, Elaine Yu and Karen Zraick.
CHICAGO The state reported 2,084 new cases of coronavirus during the past day, the most its had in months.
The last time Illinois saw more than 2,000 cases in a single day was May 24, when the state was just coming off its COVID-19 peak. But officials have warned for weeks now Illinois is seeing a resurgence; even Friday, Gov. JB Pritzker said this is a make or break moment for the state of Illinois.
The new cases mean Illinois has now seen a total of 190,508 confirmed cases of coronavirus.
Also during the past day, 21 more people died, including a man in his 30s in Cook County. There have been at least 7,613 deaths from coronavirus in Illinois.
The states positivity rate ticked up slightly to 4.1 percent.
As of Thursday night, 1,486 people were hospitalized with coronavirus in Illinois, including 333 people in the ICU and 125 people on ventilators.
Pritzker is increasing his push to get people to wear masks across Illinois in hopes it will prevent further spread of COVID-19. During a Friday press conference, he announced hes proposing rules that could see businesses fined up to $2,500 if they dont enforce mask wearing and gathering size rules.
Most people and businesses have complied with the states restrictions, which are meant to prevent the spread of coronavirus, Pritzker said. But he wants to crack down on businesses that arent following those rules.
While Illinois has made progress in its fight against coronavirus, the minority of people who refuse to act responsibly are putting others at risk, Pritzker said.
The most new cases are being seen among younger people and in central and southern Illinois, officials have said.
Block Club Chicagos coronavirus coverage is free for all readers. Block Club is an independent, 501(c)(3), journalist-run newsroom.
Subscribe to Block Club Chicago. Every dime we make funds reporting from Chicagos neighborhoods.
Already subscribe?Click hereto support Block Clubwith a tax-deductible donation.
Tony Potts, 69, a retiree from Ormond Beach, Fla., receives his first Moderna COVID-19 vaccine shot Tuesday as part of the company's phase three clinical trial. Paul Hennessy/NurPhoto via Getty Images hide caption
Tony Potts, 69, a retiree from Ormond Beach, Fla., receives his first Moderna COVID-19 vaccine shot Tuesday as part of the company's phase three clinical trial.
How much will vaccines against the coronavirus cost? Even though none has finished clinical testing, some clues about pricing are starting to emerge.
Cambridge, Mass.-based Moderna, one of the leading horses in the vaccine race, has already made deals at between $32 and $37 per dose of its experimental coronavirus vaccine in agreements with some foreign countries, rattling consumer advocates, who fear an unfair deal for U.S. taxpayers.
These Moderna prices reflected "smaller volume agreements," Moderna CEO Stphane Bancel said during a conference call Wednesday to discuss the company's second-quarter financial results. He added that the price would come down for larger volume agreements, hinting at a lower price for U.S. taxpayers.
Still, advocates are worried. Moderna has been developing its vaccine with hundreds of millions of dollars' worth of help from the federal government.
In mid-April, the drugmaker won a $483 million award from BARDA, the federal Biomedical Advanced Research and Development Authority, toward research and development of its coronavirus vaccine. And that award could ultimately be worth almost $1 billion if the company meets all its goals under the contract, according to federal records.
Moderna has been working on its vaccine with the National Institute of Allergy and Infectious Diseases, which anticipates spending an additional $410 million on the effort. This includes money for preclinical and early clinical research, but the bulk of it is going toward the crucial phase three clinical trial that began on July 27 and will include up to 30,000 people.
Given the upfront investment in the Moderna vaccine by the government, there are sharp questions about its eventual pricing. "It's a classic example of taxpayers paying twice for medicines," says Zain Rizvi, a law and policy researcher at Public Citizen focused on pharmaceuticals. "Now it wants to turn around and charge those very same taxpayers the highest public price for a potential COVID-19 [vaccine]. That's outrageous."
The federal government has been announcing procurement agreements over the past few months with pharmaceutical companies that are part of Operation Warp Speed, the Trump administration's push to have a vaccine widely available by January. So far, the prices implied by publicly released deals work out to between $4 and $20 per dose.
Moderna's procurement contract with the United States hasn't been announced, but a company spokesperson told NPR in an email that it is "committed to responsible pricing."
Pfizer's agreement with the federal government is the most lucrative to date. The government agreed to buy 100 million doses of the Pfizer coronavirus vaccine, being developed with German biotech firm BioNTech, for $1.95 billion. That works out to about $20 per dose.
Since Pfizer's contract did not include research funding from the federal government, it's not under the same pressure as some of the other vaccine makers to keep prices low for U.S. taxpayers.
The Moderna and Pfizer vaccines are expected to require two doses to protect against the coronavirus.
On July 21, U.S. Rep. Jan Schakowsky, D-Ill., asked vaccine manufacturers at a House Committee on Energy and Commerce hearing whether they would commit to selling their vaccines "at cost," meaning for no profit.
She turned to Moderna's president, Stephen Hoge, first. "We will not sell it at cost," he replied.
"You will what?" she asked.
"We will not sell it at cost," he repeated. "No, ma'am."
Merck also declined to make this pledge during the hearing. AstraZeneca said its existing deal with the U.S. didn't generate a profit, and Johnson & Johnson said it wouldn't make a profit "during the pandemic."
Moderna views pricing of its coronavirus vaccine in two stages: the pandemic period and the endemic period, CEO Bancel said Wednesday during the conference call.
"At Moderna, like many public health experts, we believe that SARS-CoV-2 virus is not going away, and that there will be a need to vaccinate people or give them a boost for many years to come," he told investors.
During the pandemic period, he said the vaccine would be priced "well below value," but afterward, it would be more in line "with other innovative commercial vaccines." That means prices could go up.
That two-tiered pricing outlook highlights the U.S. government's misstep in failing to add reasonable pricing clauses to its contracts with drugmakers, says Kathryn Ardizzone, a lawyer with Knowledge Ecology International, a nonprofit public interest group that works on intellectual property issues.
"The reality is that this is not just a free market arrangement," she says. "The U.S. government has put up a billion dollars towards the development of the vaccine, and in doing so, should have realized that it has significant leverage and [negotiated] contract terms that are favorable to the American public and worldwide."
Not everyone agrees. Adam Mossoff, a law professor at George Mason University who specializes in intellectual property, says efforts to control vaccine and drug prices during the COVID-19 pandemic could have ripple effects in the biopharmaceutical industry, ultimately stifling innovation.
He says it's a slippery slope to say taxpayers are paying twice for pharmaceuticals because they also financed part of the research. "Because the government is involved in everything in our society, the principles we're establishing would justify the government to dictate prices on not just medicines but also on all products and services from automobiles to smartphones," he says.
It's not clear exactly how much of the bill taxpayers are footing for Moderna's vaccine. Under its contract with BARDA, Moderna is required to disclose regularly the proportion of its funding that comes from the federal government. Public Citizen and Knowledge Ecology International say it hasn't.
"It appears to be violating that contract and implicitly downplayed the critical role of federal scientists in its press releases," Public Citizen's Rizvi said. "This is shocking in some way, but it's also just another example of the erasure of publicly funded science that large pharmaceutical corporations often do."
Gary Disbrow, BARDA's acting director, replied to the groups Thursday night.
"The trust of the American people is vital in the all-of-America response to the ongoing COVID-19 pandemic," Disbrow wrote, stressing his colleagues' commitment to transparency regarding vaccine development. "The contracting officer responsible for the Moderna contract has been in touch with the company and will ensure their compliance with their contractual requirements."
For a spiky sphere just 120 nanometers wide, the coronavirus can be a remarkably cosmopolitan traveler.
Spewed from the nose or mouth, it can rocket across a room and splatter onto surfaces; it can waft into poorly ventilated spaces and linger in the air for hours. At its most intrepid, the virus can spread from a single individual to dozens of others, perhaps even a hundred or more at once, proliferating through packed crowds in what is called a superspreading event.
Such scenarios, which have been traced to call centers, meat processing facilities, weddings and more, have helped propel a pandemic that, in the span of eight months, has reached nearly every corner of the globe. And yet, while some people seem particularly apt to spread the coronavirus, others barely pass it on.
Theres this small percentage of people who appear to infect a lot of people, said Dr. Joshua Schiffer, a physician and mathematical modeling expert who studies infectious diseases at the Fred Hutchinson Cancer Research Center in Seattle. Estimates vary from population to population, but they consistently show a striking skew: Between 10 and 20 percent of coronavirus cases may seed 80 percent of new infections. Other respiratory diseases, like the flu, are far more egalitarian in their spread.
Figuring out what drives coronavirus superspreading events could be key to stopping them, and expediting an end to the pandemic. Thats the million dollar question, said Ayesha Mahmud, who studies infectious disease dynamics at the University of California, Berkeley.
In a paper posted Friday to the website medRxiv that has not yet been through peer review, Dr. Schiffer and his colleagues reported that coronavirus superspreading events were most likely to happen at the intersection where bad timing and poor placement collide: a person who has reached the point in their infection when they are shedding large amounts of virus, and are doing so in a setting where there are plenty of other people around to catch it.
According to a model built by Dr. Schiffers team, the riskiest window for such transmission may be extremely brief a one- to two-day period in the week or so after a person is infected, when coronavirus levels are at their highest.
The virus can still spread outside this window, and individuals outside it should not let up on measures like mask-wearing and physical distancing, Dr. Schiffer said. But the longer an infection drags on, the less likely a person is to be contagious an idea that might help experts advise when to end self-isolation, or how to allocate resources to those most in need, said Dr. Mahmud, who was not involved in the study.
Catching and containing a person at their most infectious is another matter, however. Some people stricken with the coronavirus start to feel unwell within a couple days, whereas others take weeks, and many never end up experiencing symptoms. The length of the so-called incubation period, which spans the time between infection and the onset of symptoms, can be so variable that some people who catch the virus fall ill before the person who gave it to them does. That rarely happens with the flu, which reliably rouses a spate of symptoms within a couple days of infection.
If the coronavirus reaches a peak in the body before symptoms appear if symptoms appear at all that increase might be very tough to identify without frequent and proactive testing. Symptom-free spikes in virus load appear to happen very often, which really distorts our ability to tell when somebody is contagious, Dr. Schiffer said. That, in turn, makes it all too easy for people to obliviously shed the pathogen.
It really is about opportunity, said Shweta Bansal, an infectious disease ecologist at Georgetown University who was not involved in the study. These processes really come together when you are not only infected, but you also dont know youre infected because you dont feel crummy. Some of these unwitting coronavirus chauffeurs, emboldened to go out in public, may end up causing a superspreading event that sends the pathogen blazing through a new population.
This confluence of factors a person in the wrong place at the wrong point in their infection sets the stage for explosive transmission, Dr. Bansal said.
The teams model also pointed to another important variable: the remarkable resilience of the coronavirus when it is aloft.
A growing body of evidence now suggests that the coronavirus can be airborne in crowded, poorly ventilated indoor environments, where it may encounter many people at once. The virus also travels in larger, heavier droplets, but these quickly fall to the ground after they are expelled from the airway and do not have the same reach or longevity as their smaller counterparts. Dr. Schiffer said he thought the coronavirus might be more amenable to superspreading than flu viruses because it is better at persisting in contagious clouds, which can ferry pathogens over relatively long distances.
Its a spatial phenomenon, he said. People further away from the transmitter may be more likely to be infected.
Updated August 6, 2020
Since the start of the pandemic, many comparisons have been drawn between Covid-19 and the flu, both of which are diseases caused by viruses that attack the respiratory tract. But plenty of differences exist, and in many ways the coronavirus is more formidable. This study adds yet another layer to how its different from influenza, said Olivia Prosper, a researcher at the University of Tennessee, Knoxville who uses mathematical models to study infectious diseases but was not involved in the study. Its not just about how sick it makes you, but also its ability to transmit.
Moreover, certain people may be predisposed to be more generous transmitters of the coronavirus, although the details are still a mystery, Dr. Schiffer said.
But when a superspreading event occurs, it likely has more to do with the circumstances than with a single persons biology, Dr. Schiffer said. Even someone carrying a lot of the coronavirus can stave off mass transmission by avoiding large groups, thus depriving the germ of conduits to travel.
A superspreading event is a function of what somebodys viral load is and if theyre in a crowded space, he said. If those are the two levers, you can control the crowding bit.
Both Dr. Mahmud and Dr. Prosper noted that not everyone has the means to practice physical distancing. Some people work essential jobs in packed environments, for instance, and are left more vulnerable to the consequences of superspreading events.
That makes it all the more important for those who can participate in control measures like mask-wearing and physical distancing to remain vigilant about their behavior, Dr. Mahmud said.
Thats what we should be doing, she said. Not just to protect ourselves, but to protect others.
[Like the Science Times page on Facebook. | Sign up for the Science Times newsletter.]
